<form class="easyui-form" method="post" id="reviseBill" style="padding-left: 20px;">
    <table style="height: 20px">
        <tr>
            <th style="width: 100px;">商户名称</th>
            <td>
                <label>
                    <input type="hidden" id="billId" name="billId">
                    <input id="storeName" name="storeName" class="easyui-validatebox" style="width: 200px;"
                           data-options="required:true,prompt:'请输入商品名称'"/>
                </label>
            </td>
        </tr>
        <tr>
            <th style="width: 100px;">待结算积分</th>
            <td>
                <label>
                    <input id="accountIntegral" name="accountIntegral" class="easyui-validatebox" style="width: 200px;"
                           data-options="required:true,prompt:'请输入待结算积分'"/>
                </label>
            </td>
        </tr>
        <tr>
            <th>待结算金额</th>
            <td>
                <label>
                    <input id="accountCash" name="accountCash" class="easyui-validatebox" style="width: 200px;"
                           data-options="required:true,prompt:'请输入待结算金额'"/>
                </label>
            </td>
        </tr>
        <tr>
            <th>账单问题说明</th>
            <td>
                <label>
                    <input id="reason" class="easyui-validatebox" name="reason" style="width: 280px;"
                           data-options="required:true,prompt:'请记录账单存在的问题'"/>
                </label>
            </td>
        </tr>
        <tr>
            <th>确定结算金额</th>
            <td>
                <label>
                    <label>
                        <input id="finalAccountCash" name="finalAccountCash" class="easyui-validatebox" style="width: 200px;"
                               data-options="required:true,prompt:'请输入确定结算金额'"/>
                    </label>
                </label>
            </td>
        </tr>
    </table>
</form>
